New father Istvan Meszaros poses with his newborn daughter and stepdaughter Cecilia, who donated the egg that became Monica. Chronicle photo by Kat Wade

New father Istvan Meszaros poses with his newborn daughter and stepdaughter Cecilia, who donated the egg that became Monica. Chronicle photo by Kat Wade

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The Meszaroses say they are enjoying their new parenthood, even with its challenges, and Ilona says she'd like to get pregnant again. Chronicle photo by Kat Wade

The Meszaroses say they are enjoying their new parenthood, even with its challenges, and Ilona says she'd like to get pregnant again. Chronicle photo by Kat Wade

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MIDLIFE MOMMY / Ethical, physiological issues roil when a 56-year-old decides she wants to have another child

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2003-05-11 04:00:00 PDT Valley Springs (Calaveras County) -- Cherubic faces of adorable infants, so full of hope and promise, stared up at Ilona Meszaros from the covers of parenting magazines as she sat in the waiting room of a Sacramento fertility clinic. She flipped through the glossy pages, looking yet not really reading, trying to will away the unbearably idle minutes.

Here it was Mother's Day 2002, and this 56-year-old woman was embarking on a wondrous and controversial biomedical journey that she hoped would enable her to become one of the oldest women in America to give birth. But all Meszaros could do this day was wait for her loved ones to produce a gift for Mom far more original and labor intensive than flowers or a scarf.

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In one room at the clinic, Meszaros' 28-year-old daughter by a previous marriage, Cecilia, lay under general anesthesia, having 10 eggs removed from her ovaries. In another room, Ilona's husband, Istvan, was given a glass cup and some non-parenting magazines to help produce a sperm specimen. Twenty minutes later, Dr. Ellen Snowden, endocrinologist at Sacramento's Sher Institute for Reproductive Medicine, emerged from her lab after introducing egg to sperm in the sterile confines of a glass jar.

"I'm thinking, 'Oh, my God, I hope this works,' " Meszaros said. "My mind was racing so much that it seemed the 20 minutes went by in a flash."

Three days later, Meszaros would return to the clinic, an hour's drive from the couple's rural Central Valley home, to complete the in vitro fertilization by having four viable eggs implanted in her uterus. And two weeks after that, they would know for certain whether the procedure had worked, whether any of the four embryos would survive, whether Ilona would become one of the rare postmenopausal women to start thinking bassinets rather than empty nests.

Once, she could not have conceived of doing such a thing, but now she wanted to do this for Istvan, 48, her second husband, who had no children of his own but pined for parenthood.

Though well past menopause and with two grown daughters, Ilona searched for years to find a way to conceive, making trips to her native Hungary and also to Mexico, to no avail. No doctor would take her case because of her age and the familial egg donor. Once the couple found a specialist willing to work with a 56-year-old, and once Ilona's daughter agreed to be an egg donor, the couple spent nearly $20,000 and several anxious months to get to the Sacramento waiting room to see if nature could be nudged into taking its course.

Their Mother's Day work done, wife, husband and daughter bid Snowden goodbye and drove to a nearby Chinese restaurant for a hearty Mother's Day meal.

"Like any other family," Istvan said, laughing.

The Meszaroses, of course, are not just another family. One of those implanted eggs did, indeed, became a viable fetus. And on Jan. 27 at
Lodi Memorial Hospital
, Ilona and Istvan welcomed into the world an 8-pound, 12- ounce baby, Monica, who sported a shock of black hair and dark green eyes.

In the giddy aftermath of the birth, by cesarean section, Istvan looked at his wife cradling the newborn swathed in blankets, smiled at his stepdaughter looking on from afar, and asked the question that many still pose: "What is she, a mother or grandmother?"

Well, both.

Biologically, Cecilia is Monica's mother; it's her egg. But it was Ilona who carried Monica for nine months, Ilona whose legs swelled and back ached during a pregnancy with few complications, Ilona who rushes home from work as a seamstress in a Lodi cleaner to breast-feed Monica. It is Ilona and Istvan who wake for those 3 a.m. feedings.

Ilona is the mom. Cecilia says so herself.

"Yes, and I was happy to do this for my mother," said Cecilia, who lives in South Lake Tahoe (El Dorado County). "When I first saw (Monica), it did kind of hit me -- that baby came from part of me! But it's their baby, and I've made it a point to give them their distance these last few months. I know some people might not understand why we did it, but that's OK."

The couple's friends say they understand and approve of Monica's conception and birth. They gave Ilona a huge baby shower. Istvan's buddies at the California Youth Authority in Stockton, where he works as a teacher, slapped his back and spoke nothing but kind words. But in the biomedical community, the prospect of postmenopausal moms has raised continuing ethical debates.

The Centers for Disease Control and Prevention in Atlanta do not keep statistics on women 55 or older who give birth, but several fertility specialists say the number is fewer than 20 nationwide. The CDC reported 250 births by women between 50 and 54 in 2000, the last year data were collected. Though studies show that pregnancy in postmenopausal women poses higher risks for gestational diabetes and other complications, the technology has evolved to the point where it is safe for women pushing 60 to give birth, Snowden said.

"The uterus is just as capable of carrying a pregnancy at 50 as at 25," Snowden said. "It's more of a concern about the age of the egg donor. Many people don't understand that. As long as older women are healthy and pass a screening, there shouldn't be a problem."

"We live in a society where technology has too often outrun common sense," Loewy said. "Simply because I want something that can be done doesn't mean I have the right to it or ought to have it done. . . . To me, pursuing expensive wants like IVF when there are others needing basic medical care is the moral equivalent of standing in front of a starving man and letting him watch you eat a sandwich. It is irresponsible."

The American Society for Reproductive Medicine also has come out against postmenopausal pregnancy, stating in a 1996 ethics report, "Just as fertility is the norm during reproductive years and treating physicians are justified in their efforts to correct deficient reproductive functions, infertility should remain the natural characteristic of menopause."

Snowden, however, points to a double standard, saying that men fathering children in their 60s and 70s is accepted by society but that women are discouraged from doing the same.

"Why shouldn't someone as healthy as Ilona have that option?" she asked.

Ilona and Istvan, for their part, remain unfazed by the criticism. Ilona says it may be a cultural difference, that people in Europe might be more accepting of medical technology's helping conception. When the couple first visited a Marin County specialist, he refused to take Ilona as a patient because of her age and his "moral" concerns.

"I don't see a problem," Ilona said. "I was shocked when I got the negative reaction from the Marin doctor. He refused to work with my daughter's egg. He said it's not healthy, like breeding dogs or cats. I didn't agree with him. By using my daughter's egg, we know the baby's genetic history. We keep it in the family."

Istvan is a more vocal critic of the critics.

"We are not the only couple facing this question," he said. "We aren't (freaks). Maybe we can inspire others who are in second marriages and want to have a baby to keep at it. We proved it can happen. Ilona has given me a child,

and I think it's a miracle, and nobody can say it's the wrong thing to do."

Ilona and Istvan came to romance late. They both were born and reared in Hungary and fled to the United States in the late '60s, during political upheaval in the country. Both settled in the Bay Area, but didn't meet until 1992 at a hot tub in Calistoga. Ilona had been married, given birth to two daughters (Cecilia, 28, and Felicia, 25) and divorced and was working as a tailor in Novato. Istvan was single but ready to settle down.

They felt the attraction right away. Two weeks later, Istvan was talking marriage -- and babies.

"It didn't take me long to realize she was perfect wife material," Istvan said.

Perfect save one detail: Ilona had chosen, years earlier, to have her fallopian tubes tied to prevent her from having more children. She had two lovely daughters, teenagers by then, and considered her child-bearing years nothing but a fond memory.

"I told him, 'Too bad,' " but he kept on it," she said. "At first, when he found out I couldn't have a baby, he said he wasn't going to marry me."

"No," Istvan said, "I didn't put it like an ultimatum. But it did take me 11 months to get her to consider finding a way to have a baby."

"But I remember telling you, 'I'd love to, but how the hell can I?' " Ilona said. "That door was closed. But I loved him so much I was open to suggestions. "

"They gave me a couple of years to think it over," Cecilia said. "I was a little surprised at first. But I know my mom. She's a tough woman. She's very strong. And she's healthy. Age doesn't matter to her."

Once the Meszaroses found Snowden and the Sher Institute, Ilona and Cecilia began 12 weeks of hormone therapy. For Cecilia, the twice-weekly injections stimulated her egg production. For Ilona, it restored her menstrual cycle, which she said took some getting used to.

"I didn't have my period for seven years, and then, boom, it's back," Ilona said. "But it happened right on schedule, right with my daughter's cycle. It was exciting. I've always been close to Cecilia, and this was something we could share."

Once the eggs were extracted from Cecilia, fertilized and transferred to Ilona's uterus, Cecilia's work was done. Ilona stopped taking hormones, as well, since at nine weeks of pregnancy, the placenta takes over hormonal production. Though she was pregnant during the hot summer months in the Central Valley, and though she continued to work up to the week before her due date, Ilona said her pregnancy was "a wonderful experience." She experienced no complications other than a minor liver ailment unrelated to advanced age, according to obstetrician Leslie Sackschewsky.

In her eighth month, Ilona's old friends threw her a baby shower. For most of the women in attendance, it was a shock to learn one of their peers was pregnant. They were supportive, but it took a little getting used to.

"I never imagined anything like this," said Eva Horvath, of Novato, Ilona's friend of 20 years. "But that's Ilona. She's always so full of energy. She worked seven days a week, sewing clothes, and had two jobs. She's a real go- getter. If anyone 56 would have a baby, it'd be her."

Elizabeth Galicz, who threw the shower for Ilona, almost choked on the cucumber salad she served at the party when Ilona insisted on a blow-by-blow account of the baby's in vitro fertilization.

"I'm very happy for her, but I wouldn't want to go through being pregnant again," Galicz said. "I like having my kids grown and out of the house and having my nights free again. But everyone's different."

At the grocery store checkout stand, the bagger gushed over baby Monica as Ilona pays the bill. A woman approached and said, "Oh, what a beautiful baby!" The bagger, who knows the Meszaroses, pointed to Ilona said, "And she's the mother, not the grandmother." The woman could not hide her surprise and gasps. Ilona only smiled.

Most folks in Valley Springs know the story by now. The local paper in Lodi ran a banner headline the day after the birth, with a picture of Dad, Mom and child in the hospital bed. But occasionally, their family dynamic takes some explaining, which Istvan is happy to do.

"I didn't count on such an overwhelmingly great response from strangers," he said. "In the store, at the post office, everybody's had an open mind. Even people here who identify themselves as Christians have been OK with it. What we did is not against any creed or faith or value. It might be against custom in this country, but I just tell people we're living in a technological age."

It has been tougher answering other questions, though.

"People say, 'But you'll be in your 70s when she's in high school.' And they ask, 'What if you die?' " Ilona said. "Well, simple. I have my daughter to take care of her if anything happens to me. My parents are both 84 and still working full time in Hungary. I've got good genes. Istvan's parents are still alive, too. We're going to give Monica a good start in life and then, who knows? Make sure she's loved until she's 21, then let her go."

Motherhood, she said, is neither harder nor easier now than in the '70s, when Cecilia and Felicia were being reared. It's just . . . different. As she did with her older daughters, Ilona supplements breast milk with goat milk for Monica. Already, at 3 months, Monica is sleeping through the night -- most nights.

Istvan, a doting father, volunteers to be the lead diaper changer and uncomplainingly wakes at all hours to succor Monica during crying jags.

"Everything's changed for me, but I love it," he said. "I'm much better prepared for this than if I'd had a child 10 years ago."

Chris Gruen, psychologist at the California Youth Authority and a co-worker of Istvan's for many years, said, "When he first told me his plan, I'm like, 'Think it through, buddy.' But, really, he's always wanted to be a father and it would've been a real loss had this not happened. I've never seen a guy more happy or more proud than Istvan. He called it the pivotal moment of his life."

Postpartum, everyone was elated -- except Cecilia.

One look at Monica, and Cecilia's maternal feelings surfaced. She said she didn't expect such a reaction. Throughout the pregnancy, Cecilia referred to Monica as her sister. Afterward, she started feeling as if Monica were her daughter.

"It hit me really hard," she said. "It was very emotional, and I had really mixed feelings. I decided to stay away and give my mom and (Istvan) distance so they could bond with the baby."

Ilona said that Cecilia (who has a common-law marriage) had been trying to conceive for several years, without success.

"Maybe she was a little jealous, after seeing Monica," Ilona said. "She was bound to have some feelings like that."

Last week, as a sort of advanced Mother's Day gift for 2003, Cecilia called Ilona and told her the big news: She's pregnant. Cecilia's baby is due in December, making Ilona a grandmother for either the first or second time, depending on how Monica is categorized.

"This whole thing has been very bizarre and kind of a miracle," Cecilia said. "I'm nervous about it, but I'll have my mom there to help. The two babies can grow up together."

Make that three -- perhaps.

Ilona said she is not finished. She wants to have another baby, as soon as next year, and she's exploring the possibility of having younger daughter Felicia supply the eggs next time.

"This is nothing," she said, smiling. "There's a lady in Italy who had a baby when she was 66. I'm still young."